Review: Key questions to ask in bioethics…



  • What is the ethical question?


  • What are the relevant facts necessary to think carefully about it?


  • Who or what could be affected by the way the question gets resolved?


  • What are the relevant ethical considerations?
    • Respect for persons
    • Maximize benefits while minimizing harms
    • Justice or fairness

Its a bold new world in modern science…


  • Advancements in biotechnology and medicine have created new ethical issues never before faced by humanity
    • YOU will face ethical questions that your parents never had to contend with


  • Current themes in bioethics:
    • Human reproduction
    • Shaping human beings
    • Beginning and end of life
    • Health and society
    • Food, farming and the environment
    • Crime and security
    • Research ethics
    • Vaccine distribution

Just because humans CAN do something, SHOULD we?

Genetic testing and genomics





  • The ability to perform sophisticated genetic tests or sequence an entire genome is revolutionizing diagnosis of disease
    • increasing tests are non-invasive


  • Prenatal tests can diagnose potentially fatal diseases


  • Many diseases with adult onset have gene alterations that are not causative but associated with it
    • e.g. Alzheimer’s and APOE

Genetic testing and genomics


  • Who should be allowed to see this information?
    • Insurance companies?


  • Is it better not to know?
    • Many individuals experience high levels of stress and anxiety after test results


  • Should a fetus with a fatal disease be terminated
    • Down-syndrome vs autism vs IQ
    • What about false-positives?


  • What would be the consequence of mass genetic screening?
    • Stigmatization
    • Eugenics concerns

Gene editing and genetically modified organisms



  • CRISPR-Cas9 has now made gene editing a reality in nearly any type of cell
    • including a human embryo



  • Chinese scientist used CRISPR on human embryos to edit the receptor that HIV uses to gain entry


  • Crops are being modified to withstand various ecological challenges
    • genetically engineering C4 photosynthesis

Gene editing and genetically modified organisms



  • Alterations may increase the likelihood of one disease while protecting you from others


  • Possibility of mistakes exists
    • Risks further damage to health
    • Long-term effects?


  • Opens door for cosmetic changes in humans


  • Consequences for the natural world
    • Should we alter species DNA to save biodiversity?

Reflection: How do you feel about gene editing?

Stem cell research and therapy


  • Stem cells can be obtained from an embryo or induced from somatic cells

  • Great promise for disease-specific cell lines and regenerative medicine products

  • Stem cells are stored in biobanks to provide blood transplantation resources

Stem cell research and therapy



  • Creation of embryos specifically for research purposes
    • and destruction


  • Status of organoids generated


  • Use of animal models and potential for xenografts


  • Economic interference: the potential to overpromise and overexpect


  • Identity concerns after patient donations of stem cells

Cloning





  • Cloning of humans is almost certainly possible at this point
    • Human embryos cloned: 2001
    • Adult human cells transformed into embryonic cells: 2007
    • Genetic material from skin cells grown into embryo: 2011


  • There are potential uses for regenerative medicine
    • cloned embryos a source for stem cells

Cloning


  • Would a clone be the same person?
    • Phenotype versus genotype
    • How to distinguish a clone from the original?


  • Psychological harm to a human clone:
    • Should a clone have the same rights?
    • Societal issues
  • Low success rate of cloning—many abort late term


  • Cloned organisms may develop health problems

Wildlife ethics: Handling invasive species




  • Negative consequences of invasive species are far-reaching
    • 42% of threatened/endangered species are at risk
    • Commercial, agricultural, and recreational activities depend on healthy native ecosystems


  • Invasive species’ are the villains of the wildlife conservation world.


  • Management of invasive species is expensive
    • U.S. loses $13 billion annually in crops from invasive insects
    • Eurasian watermilfoil (aquatic plant) reduced Vermont lakefront property ~16%

Wildlife ethics: Handling invasive species


  • Is the demonisation of ‘invasives’ morally wrong?
    • Management usually results in the killing of the species
    • Narrative oversimplifies complex biological processes


  • Biocontrol often fails
    • Is it ethical to introduce a predator into a system?


  • Are the terms ‘invasive’, ‘non-native’ and ‘foreign’ morally appropriate?
    • Consider the human perspective
    • Many non-native species have little impact


  • War rhetoric often used to describe the behaviors of invasive species
    • Insects, molluscs, plants, etc. are not intent on destruction

Global health disparities





  • Healthcare and life expectancy in underdeveloped countries lags far behind first world countries


  • Sub-saharan African countries: 20-25 years lower


  • Do richer countries have an obligation to act?


  • Socio-economic background a major factor in the US

Global health disparities



  • Moral responsibility to minimize suffering
    • disease burden impart due to life-sytle choice


  • What is the relationship between health ethics and human rights?
    • Governments obligation to respect, protect, and fulfill human rights
    • Protecting community health may require limiting the liberty of people
    • Limited resource distribution


  • Goes beyond a health issue
    • Affects security and economics